Reducing the Risk of Cross‐Contamination From Transmissible Spongiform Encephalopathies

Abstract

IN RESPONSE TO RECENT REPORTS from several major US medical centers regarding possible exposure of surgical patients to transmissible spongiform encephalopathies (TSEs), one institution developed guidelines to care for surgical patients with the preoperative diagnosis of "rule out TSE." BASED ON CURRENT sterilization technology, using disposable surgical instruments may be the safest way to eliminate concerns of iatrogenic transmission of TSE and reduce the number of hospital staff members who could be exposed to the TSE contagion. PERIOPERATIVE PRECAUTIONS that can be taken when patients are undergoing brain biopsy procedures to rule out TSE are detailed.

Special Needs Populations: Perioperative Care of the Patient With Creutzfeldt‐Jakob Disease

“…The following are intraoperative recommendations and practices reported by some neurosurgical facilities that were shown to significantly lessen the time required for OR personnel to perform proper postoperative cleaning: Allow only essential items in the room, such as the anesthesia machine, one suction unit, one monopolar/bipolar electrosurgical unit, one back table, one Mayo stand, one sharps container, and one biohazard garbage bag 59 Cover all pedals and cords with plastic bags and secure them in place 59 Cover all other equipment, the walls, the bed, and the floor of the working area with sheets of polyvinyl chloride (Figure 3).…”

“…Cover all other equipment, the walls, the bed, and the floor of the working area with sheets of polyvinyl chloride (Figure 3). 59,60 Another neuroscience center has used disposable liquid‐repellent sheets (eg, surgical drapes and heavy‐duty surgical table covers) to achieve the same goal.These efforts have been shown to facilitate relatively easy disposal of potentially contaminated material 53 …”

“…Allow only essential items in the room, such as the anesthesia machine, one suction unit, one monopolar/bipolar electrosurgical unit, one back table, one Mayo stand, one sharps container, and one biohazard garbage bag 59 …”

“…Specimen handling for a CJD biopsy does not require special considerations and can follow hospital protocols for routine care 59 . Additional labeling and double bagging can be used to alert those handling the container of its contents and avoid any opportunity for spillage 61 .…”